Good outcome of neuromyelitis optica: a case report / 国际眼科杂志(Guoji Yanke Zazhi)

ABSTRACT

A 26 year-old Malay man presented with first attack of left eye optic neuritis that recovered fully with intravenous methylprednisolone after 3 weeks. He developed a second attack of optic neuritis in the right eye the following week. Lhermitte sign as well as Uthoff phenomenon were also positive. On day-3, he developed bilateral paraplegia and sensory loss at T8 level, which progressively worsen and became bedridden on day-5. MRI showed bilateral enhance-ment of the optic nerve with the presence of long multisegmental demyelinating plaque in the thoracic to lumbar spinal cord and the brainstem, sparing the brain hemisphere. He was promptly given high dose intravenous methylprednisolone followed by oral predni-solone. He was also assigned on intensive neuro-phy-siotherapy. He recovered after 3 months and was able to walk with walking aids. He recovered completely after 7 months and resumed working as site contactor. There was no relapse during the last 1 year follow-up. His final visual acuity improved to 6/9 in the right eye and 6/6 in the left eye. The visual field of the right eye showed per-sistent mild cecocentral scotoma. And diffuse depression.